How stress can break your heart
Stress often affects behaviour that increases heart disease risk: smoking, physical inactivity and overeating
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There’s no escaping stress, given the times we live in. And there is no escaping the fact that it affects health—it could lead to headache, back strain, stomach pain. It may zap your energy, make you lose sleep, become cranky, even forgetful.
It can also have a big impact on your heart. “The effect of stress on the heart is multifold,” says Nihar Mehta, consultant (interventional cardiologist) at Mumbai’s Jaslok Hospital. Due to stress, the body’s “flight or fight” system gets charged up, leading to a cascade of untoward changes in heart rate (leading to pounding in the chest), a rise in blood pressure, the tightening of blood vessels, even platelet aggregation—clumping, causing the blood to become thicker and clot easily. “When this happens in the heart vessels, it can lead to a heart attack or even sudden death,” says Dr Mehta, adding, “That is why it is important to keep a lid on stress.”
Viveka Kumar, director, Cath Lab, Max Super Speciality Hospital, New Delhi, points out that heightened activity in the amygdala is associated with a greater risk of heart disease and stroke. When someone experiences a stressful event, the amygdala, an area of the brain that contributes to emotional processing, sends a distress signal to the hypothalamus.
As part of a study, published in the Lancet journal in January, 293 patients were given a combined PET/CT scan to record their brain, bone marrow and spleen activity and inflammation of their arteries and were then tracked for an average of 3.7 years to see if they developed cardiovascular disease. The researchers found that heightened activity in the amygdala was linked to increased bone marrow activity and inflammation in the arteries, leading to increased cardiovascular risk—clearly showing the direct link between stress and heart disease.
There is an indirect connect too. Stress often affects behaviour that increases heart disease risk: smoking, physical inactivity and overeating. “Often, in my practice, I see stress leading people to drink too much alcohol or smoke, and how these habits increase blood pressure and damage artery walls,” says Dr Kumar.
Dr Mehta says there are two factors. First, stress stems from life events, disasters or crises. “It can have the face of a malicious boss or come in the form of losing of a job, demonetization, divorce, personal illness… the list goes on,” says Dr Mehta, adding that it’s no longer uncommon to see people suffering a heart attack in their 30s owing to stress.
One kind of heart attack, stress cardiomyopathy, is believed to be caused by sudden emotional stress, and is often referred to as the “broken-heart syndrome”.
A study published in the JAMA Internal Medicine journal in 2014 found that individuals who had lost a spouse or partner were more likely to have a heart attack or stroke within the next 30 days. The researchers say that emotional stress wreaks havoc on the sympathetic nervous system responsible for revving up the body’s fight-or-flight response.
Dr Kumar adds, “...there is also the fact that there’s often a tendency after such a profound loss for the surviving spouse or partner to disregard his or her own health and become resigned to dying.”
Second, stress can be related to work, home or finances and certain personality traits—hostility, cynicism and aggression—that can raise the risk of cardiovascular disease.
Depression too can be responsible for coronary artery disease. Not only does depression lead to physiological changes in heartbeat, blood pressure and blood clotting, it can also result in behavioural changes, such as overeating, smoking, or becoming irregular with medication. And depression is often triggered by chronic stress.
“Stress is actually one of the modifiable risk factors for cardiovascular disease… so it is important to modify the stress in your life, to learn to cope with it before it sinks your heart,” says Dr Mehta.
So what can you do? “Exercise, maintain a positive attitude, not smoke, not drink too much. Essentially, have a healthy diet and stay positive,” says Dr Kumar.
Medicines are helpful for many things, but usually not for stress. Some people take tranquilizers for immediate effect, but it’s far better in the long term to learn to manage stress through relaxation or stress management techniques, says Dr Kumar. “You also need to identify situations that make you feel stressed and try to deal with them in a healthy and positive manner,” he adds. Take help from a specialist if you need to